SUBMIT YOUR CONSUMER FINANCE APPLICATION ONLINE

Welcome HomeCare Finance Partner

We have provided a simple page to apply for consumer financing directly through our online portal. When you submit a consumer application it is very important that you have a signed copy of the consumer lease application on file. Consumer privacy laws protect consumer credit request so it is important to maintain records of all transactions.

Once HomeCare Provider Services receives the application we will process your Loan Amount Request and Provide Sales Person with the required documents to secure the Lease with Length of Terms available for Applicant.

HomeCare Provider Requesting Consumer Financing

* Indicates required field

HomeCare Provider Company Name *

To Apply for Consumer Financing for your location you must be an approved Vendor. Please Provide your company name.

Sales Person *

Please provide the name of the Sales Person that is initiating the Financing Request for the Consumer.

Sales Person Email Address *

Consumer Financing Lease Application

Equipment Description Financed *

Please Provide the Equipment Description and Model#

Loan Amount Requested *

Please provide the requested amount of financing

Consumer Information "Primary" Applicant

​* denotes required fields

Applicant Name *

First

Last

Applicant Social Security Number *

Home Phone Number *

Date of Birth *

Email Address *

Applicant Address *

Line 1

Line 2

City

State

Zip Code

Country

Please provide Street Address, City, State and Zip Code

Own Residence *

YesNo

Years at Residence *

Employer *

Job Decription Title *

What is the Consumers current title or job description if available.

Work Phone Number *

Consumer Information "Co-Signer" if applicable

Co-Signer Name *

Co-Signer Social Security Number *

Co-Signer Home Phone *

Co-Signer Date of Birth *

Email Address *

Employer *

Job Decription Title *

Work Phone Number *

Co-Signer Address *

Line 1

Line 2

City

State

Zip Code

Country

Own Residence *

YesNo

Years at Residence *

The Applicant applies for the Lease to Own Financing indicated in this application, and that HomeCare Provider Company has a Signed Consumer Financing Lease Application on file for reference. Everything stated in this application is correct. TimePayment Corp. may retain or request a copy of the Signed Application whether or not the Lease is approved. TimePayment Corp. and it Authorized Affiliates are authorized to check the applicants credit for the purposes of determining applicants credit worthiness at the time of submission of application or thereafter in connection with the same transaction or extension of credit and for the future purpose of reviewing the account, taking collection activity on the account, and skip tracing. TimePayment Corp. and it's Authorized Affiliates are authorized to provide history information to others about Applicants credit standing and Applicants credit experience with HomeCare Provider Company, including but not limited to credit bureaus, other companies, outside collection agencies and outside attorneys.

Lease Package Requirements

Signed Lease AgreementHomeCare Provider Invoice for EquipmentCheck made payable to TPC for Fee & PaymentNotice of cancellation for consumer transactions excluding retail sales

Credit Guidelines

Application Only​Transactions > $500

Approval Conditions

Approvals valid for 30 days​ACH required for transactions > 10K

Leasing Program Requirements

1st Payment in Advance with Credit Card or Check.

Verification Equipment for Payment

​To speed up the verification process you may ask your customer to contact us to verify the lease from their place of business or residence Monday through Friday from 9:00 a.m. EST to 7 p.m. EST at 1-877-868-3800 ext. 1607.